David Rosen, MD, PhD, associate professor of medicine in the division of infectious diseases, is principal investigator of a study that will review the North Carolina Formerly Incarcerated Transition (NC FIT) Program, funded by a three-year Duke Endowment Award.
Founded in 2018 by Evan Ashkin, MD, professor of family medicine, NC FIT connects formerly incarcerated individuals who have a chronic disease, mental illness and/or substance use disorder with appropriate healthcare services and other reentry resources.
“When Evan founded NC FIT, it was clear that this was a really important accomplishment because there is such a huge gap in our public health infrastructure for those being released,” Rosen said. “Since its founding, I have gradually become more involved in the NC FIT program’s evaluation efforts.”
NC FIT is a partnership between UNC Family Medicine, the North Carolina Department of Public Safety (which administers the state prisons), the North Carolina Community Health Center Association, Federally Qualified Health Centers, County Departments of Public Health, community-based reentry organizations and local reentry councils.
Rosen explained how the award will accomplish long-time goals.
“The first goal is to more comprehensively characterize the use of health care among people in the NC FIT program. The second is to bring more rigorous methods to assess the impact of the NC FIT program on health, health care outcomes, and costs. And third, in partnership with colleagues at the State Center for Health Statistics, we plan to develop an infrastructure to routinely assess for health disparities among people released from prison. At the state level, creating such a system can foster broader understanding of the close connection – really the inseparability– of prison health from community health. “
Ashkin said the project will help to determine the effectiveness of NC FIT to address these issues, and its impact on access and disparities if it were expanded further across the state.
“NC FIT is still the only statewide organization focused on connecting people to essential health services after release from jail or prison,” said Ashkin. “We struggle to provide funders, policy makers and others with regional data about our work to support expansion across the state. We are very excited about the Duke Endowment supporting our efforts to understand how to better serve this highly marginalized and vulnerable population.”
The Division of Infectious Diseases has provided HIV care in the prison system for more than two decades. In the late 90s, Rosen began working as a research assistant, mentored by several ID faculty who were providing care in prison.
“My experience was a formative one, as it opened my eyes to thinking of incarcerated persons – as that – people and not some abstract idea or stereotype of prisoners. I also gained an appreciation for the many challenges that people in prison can face in accessing care not only during incarceration but also when returning to the community. It was clear that there was a great need for more research, evaluation, programs, and policies– for not only HIV, but across the board — to improve access to care for this population. I’ve been essentially working in the field ever since.”